44 years old, MTF. 18 months HRT. Any tips on passing better? Open to surgery recommendations. I already finished my consult with Dr. Tommy Liu in Seattle and Dr. Keojampa in San Francisco. Dr. Tommy Liu has refused to operate on me due to my having sleep apnea and needing CPAP. Dr. Keojampa felt comfortable proceeding even though I have apnea, so I will be going with Dr. Keojampa.
Do note that I just had a hair transplant completed last month. You will see the new hairline in the photo. I won't be seeing results for about 4-8 months.
Surgeries I've already completed:
- Hair transplant by Dr. Gabel in Portland (currently healing from it, should see results in 8 months, Dr. Gabel says 2nd round FUT is likely needed). Tried minoxidil and finasteride for over a year, no luck. So I went with hair transplant.
- Modified Wendler Glottoplasty by Dr. Yung in San Francisco. It took my voice from quite masculine to androgynous masculine. Not where I'd like it to be, planning on doing a revision next year once I finish all other surgeries since VFS results in being required by surgeon to put all other surgeries requiring intubation on hold for six months after VFS.
- Bilateral Simple Midline Orchiectomy by Dr. Sara Spettel in Portland - went well.
Pending surgeries:
- Vulvoplasty and vaginoplasty via jejunal flap with Dr. Del Corral on November 7, 2025.
- 2nd round of hair transplants (FUT) in December 2025
As you can see above, I haven't done any surgeries in regards to my face. So this is where this post comes in, are there any surgeries that I could benefit from that would make me much less clockable?
When I look in the mirror, I still see pretty masculine features in my face. My guess, chin could benefit from being less boxy, could use some nose work so it doesn't look bulbous, while glasses hide it, my eyebrow ridges could benefit from reduction, lip fat graft to make them more feminine, hairline advancement, blepharoplasty, and neck lift with liposuction.
Medical notes if it's relevant -- I'm on:
- Estradiol Valerate via injection every 3.5 days
- Progesterone via suppository daily
- Low dose testosterone cream daily (as my T was undetectable, helped to fix my libido)
- Lisinopril for high blood pressure
- Zepbound for weight loss and to reduce sleep apnea
I'm looking forward to your recommendations for surgery options. Thanks in advance!